Preeclampsia is a multiorgan syndrome that develops in the second half of pregnancy, characterized by hypertension associated with albuminuria or multiple organ dysfunction.
|Proteinuria: ≥300 mg of protein in 24-hour urine or protein/creatinine ratio ≥30 mg/mmol|
|Renal failure: Blood creatinine 90 μmol/L|
|mpaired liver function: Increased liver enzyme levels in the blood to 2 times the normal threshold or abnormal lower back pain|
|Neurological complications: eclampsia, stroke, confusion, headache, temporary blindness, visual disturbances|
|Blood complications: platelets <150,000/dL, disseminated intravascular coagulation syndrome or bleeding.|
|- Pregnant with a baby |
- Multiple pregnancy
- History of pregnancy preeclampsia
- Systemic lupus erythematosus
- Hereditary hemophilia
|- Chronic hypertension- Hereditary hemophilia |
- Body mass index (BMI) before pregnancy from over 35 kg/m2
- Antiphospholipid syndrome
- Diabetes and gestational diabetes
|- Pregnant mother from over 35 years old |
- Kidney disease
- Use assisted reproduction methods
- There is an obstructive sleep apnea
According to ACOG's recommendations, these subjects should be identified as high-risk groups and need preventive treatment, however, if only following ACOG's recommendations, up to 50% of those who need to be treated can be missed. must be treated.
The current pregnancy management approach applies a pyramid model, in which determining the risk for complications later in pregnancy is the basis for developing an appropriate management plan.
Current evidence points to a two-stage screening model:
- Parameters related to the mother's history, ultrasound information, examination information will be combined to calculate the risk of preeclampsia in the mother.
- The ratio sFLT-1/PlGF has prognostic value in cases where it is necessary to predict complications of preeclampsia.
- First trimester: PlGF index (from 10 to 13 weeks gestation) combined with maternal history, examination information and ultrasound results.
- The second and third trimesters: The ratio sFLT-1/PlGF predicts poor pregnancy outcomes of pregnant women (from the 19th week of pregnancy) combined with maternal history, examination information and ultrasound results.
- Sample: 2ml of peripheral blood
- Time to return results: 2 days
1. Rolnik, Daniel L. et al. Prevention of preeclampsia with aspirin Rolnik, Daniel L. et al. American Journal of Obstetrics & Gynecology, Volume 0, Issue 0
2. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260.
3. Trần Mạnh Linh: nghiên cứu kết quả sàng lọc bệnh lý tiền sản giật - sản giật bằng xét nghiệm PAPP-A, siêu âm DOPPLER động mạch tử cung và hiệu quả điều trị dự phòng. 2020 – Đại học Y Dược Huế